Gateway conformance validation

ABSTRACT

A patient record gateway of an electronic health record system can be validated using a conformance statement that defines capabilities and characteristics of patient record servers associated with the gateway. Part of validating the patient record gateway includes performing a configuration test of the patient record gateway using the conformance statement.

BACKGROUND

Users typically visit more than one health institution (e.g., medicalproviders) to obtain medical treatment. For example, a user mayperiodically visit a neighborhood clinic for annual physical evaluationsand for minor medical procedures. An electronic health record (EHR) is acomputer-stored and transferrable copy of a user's physical healthrecord. The neighborhood clinic may maintain an instance of the user'selectronic health record (e.g., using an EHR system, sometimes referredto as an electronic medical record (EMR) system). When the user visits aprovider, a medical professional may update the electronic healthrecord. However, different instances of the user's electronic healthrecord may be maintained by other health institutions that areunaffiliated with the neighborhood clinic, which may use differentversions of the same EHR system or may even use completely different EHRsystems (e.g., developed by a competing company). Thus, instances of theuser's health record may be distributed among multiple healthinstitutions, and depending on which type and version of EHR systemsused by the health institutions, their records may be stored usingmultiple different EHR types and versions.

A health record sharing system can include functionality for patients todownload these disparate instances of their health records to their userdevices. For a health institution to have its records available on thehealth record sharing system, the health institution may be required toparticipate in an onboarding process defined by an operator of thehealth record sharing system. During the onboarding process, anadministrator or other user of the health institution inputs informationthat describes many technical aspects of the health institution's EHRsystem. Existing onboarding processes can be time-consuming and errorprone.

BRIEF SUMMARY

A system of one or more computers can be configured to performparticular operations or actions by virtue of having software, firmware,hardware, or a combination of them installed on the system that inoperation causes or cause the system to perform the actions. One or morecomputer programs can be configured to perform particular operations oractions by virtue of including instructions that, when executed by dataprocessing apparatus, cause the apparatus to perform the actions. Onegeneral aspect includes a computer system, including: a first userinterface configured to receive a gateway identifier corresponding to apatient record gateway, the patient record gateway associated with oneor more patient record servers configured for storing electronic healthrecords for a plurality of patients, and a memory includingcomputer-executable instructions that, when executed by a processor,cause the processor to access a gateway conformance statement based atleast in part on identifying information associated with the patientrecord gateway, the gateway conformance statement definingcharacteristics and capabilities of the one or more patient recordservers. The processor also performs a configuration test of one or morecapabilities of the patient record gateway using the gateway conformancestatement and a set of test patient credentials. The processor also, inaccordance with a determination that the patient record gateway passesthe configuration test, adds the patient record gateway to a list ofsupported patient record gateways. The computer system also includes asecond user interface configured to present the list of supportedpatient record gateways. Other embodiments of this aspect includecorresponding computer methods, apparatus, and computer programsrecorded on one or more computer storage devices, each configured toperform the actions described herein.

Implementations may include one or more of the following features. Thecomputer system where performing the configuration test of the one ormore capabilities includes: validating the one more capabilities. Thecomputer system may also include validating one or more characteristicof the patient record gateway. The computer system where the memoryincludes additional computer-executable instructions that, when executedby the processor, further cause the processor to at least: parse thegateway conformance statement based at least in part on results of theconfiguration test. The processor may further define a gateway schemafor the patient record gateway based at least in part on parsing thegateway conformance statement. The computer system where the gatewayschema defines a protocol for authorization of a patient and retrieval,by the patient using a user device, of a portion of an electronic healthrecord of the patient that is hosted by the patient record gateway. Thecomputer system where accessing the gateway conformance statementincludes requesting the gateway conformance statement from the patientrecord gateway and receiving the gateway conformance statement from thepatient record gateway. The computer system where the patient recordgateway includes a test version of the patient record gateway thatoperates in a test environment. The computer system where adding thepatient record gateway to the list of supported patient record gatewaysincludes, in accordance with the determination that the test version ofthe patient record gateway passes the configuration test, adding aproduction version of the patient record gateway to the list ofsupported patient record gateways. Implementations of the describedtechniques may include hardware, a method or process, or computersoftware on a computer-accessible medium.

One general aspect includes a computer-implemented method, including:receiving a gateway identifier corresponding to a patient recordgateway, the patient record gateway associated with one or more patientrecord servers configured for storing electronic health records for aplurality of patients. The computer-implemented method also includesaccessing a gateway conformance statement based at least in part onidentifying information associated with the patient record gateway, thegateway conformance statement defining characteristics and capabilitiesof the one or more patient record servers. The computer-implementedmethod also includes performing a configuration test of a plurality ofcapabilities of the patient record gateway using the gateway conformancestatement and a set of test patient credentials. Thecomputer-implemented method also includes in accordance with adetermination that the patient record gateway passes the configurationtest, adding the patient record gateway to a list of supported patientrecord gateways. Other embodiments of this aspect include correspondingcomputer systems, apparatus, and computer programs recorded on one ormore computer storage devices, each configured to perform the actions ofthe methods.

Implementations may include one or more of the following features. Thecomputer-implemented method where performing the configuration test ofthe plurality of capabilities includes instructing a test harness toperform the configuration test by simulating authorization of a testpatient using the set of test patient credentials and simulatingretrieval of a test electronic health record associated with the set oftest patient credentials. The computer-implemented method furtherincluding providing a user interface for presentation at a user device,the user interface including the list of supported patient recordgateways. The computer-implemented method where the patient recordgateway is one of a plurality of patient record gateways provided by apatient record vendor, each patient record gateway of the plurality ofpatient record gateways associated with a particular gateway conformancestatement. The computer-implemented method where the one or more patientrecord servers are further configured for outputting electronic healthrecord information in accordance with one or more predefined standards.The computer-implemented method where the one or more predefinedstandards includes the Fast Healthcare Interoperability Resources(FHIR®) standard. The computer-implemented method where thecharacteristics of the gateway conformance statement (also calledcapability statement) include an authorization uniform resource locator(URL), a token URL, a resource URL, a first list of supported resources,a second list of supported search parameters, and types of supportedinteraction. The computer-implemented method where performing theconfiguration test includes: verifying connectivity of the one or morepatient record servers of the patient record gateway using the gatewayconformance statement. The computer-implemented method may also includeverifying conformance of the patient record gateway with one or morepredefined standards for patient record storage and transmission basedat least in part on the gateway conformance statement. Thecomputer-implemented method may also include simulating authorization ofa user device by the patient record gateway based at least in part ontest patient credentials. The computer-implemented method whereperforming the configuration test includes: identifying one or moreresources associated with the patient record gateway based at least inpart on the gateway conformance statement, the one or more resourcesbeing available at the one or more patient record servers of the patientrecord gateway. The computer-implemented method may also include parsingthe gateway conformance statement to create one or more gateway schemasfor accessing patient record data from the one or more resources. Thecomputer-implemented method where performing the configuration testfurther includes: accessing the one or more resources to obtain testpatient record data in accordance with the one or more gateway schemas.The computer-implemented method may also include comparing the testpatient data obtained from the one or more resources with a user datastandard specification for patient record storage on a user device.Implementations of the described techniques may include hardware, amethod or process, or computer software on a computer-accessible medium.

One general aspect includes one or more computer-readable mediaincluding computer-executable instructions that, when executed by one ormore computer systems, cause the one or more computer systems to performoperations, including: performing a configuration test of a patientrecord gateway by at least verifying connectivity of one or more patientrecord servers of the patient record gateway based at least in part on agateway conformance statement, the gateway conformance statementdefining characteristics and capabilities of the one or more patientrecord servers. The operations also include verifying conformance of thepatient record gateway with one or more global standards for patientrecord storage and transmission based at least in part on the gatewayconformance statement. The operations also include identifying one ormore resources associated with the patient record gateway based at leastin part on the gateway conformance statement, the one or resources beingavailable at the one or more patient record servers of the patientrecord gateway. The operations also include parsing the gatewayconformance statement to create one or more gateway schemas foraccessing patient record data from the one or more patient recordservers. The operations also include generating a notification includinga result of the configuration test. Other embodiments of this aspectinclude corresponding computer systems, apparatus, and methods, eachconfigured to perform the actions described herein.

Implementations may include one or more of the following features. Theone or more computer-readable media where performing the configurationtest further includes: accessing the one or more patient record serversto obtain test patient record data in accordance with the one or moregateway schemas. The operations also include comparing the test patientdata obtained from the one or more patient record servers with a userdata standard specification for patient record storage on a user device.The one or more computer-readable media where performing theconfiguration test further includes simulating authorization of a userdevice by the patient record gateway based at least in part on a set oftest patient credentials. Implementations of the described techniquesmay include hardware, a method or process, or computer software on acomputer-accessible medium.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a block diagram and a flowchart for onboarding ahealth institution to a provider cloud using a conformance statement,according to at least one example.

FIG. 2 illustrates a block diagram showing an example architecture orsystem for onboarding a health institution to a provider cloud using aconformance statement, according to at least one example.

FIG. 3 illustrates a data flow for onboarding a health institutionincluding a custom electronic health record system to a provider cloudusing a conformance statement, according to at least one example.

FIG. 4 illustrates a data flow for onboarding a health institutionincluding a commercial electronic health record system to a providercloud using a conformance statement, according to at least one example.

FIG. 5 illustrates a data flow for creating a gateway schema for agateway of a health institution, according to at least one example.

FIG. 6 illustrates a user interface for obtaining configuration data fora gateway of a health institution, according to at least one example.

FIG. 7 illustrates a user interface for obtaining configuration data fora gateway of a health institution, according to at least one example.

FIG. 8 illustrates a user interface for presenting a list of supportedgateways, according to at least one example.

FIG. 9 illustrates an example flow chart showing a process foronboarding a health institution to a provider cloud using a conformancestatement, according to at least one example.

FIG. 10 illustrates a simplified block diagram depicting an examplearchitecture for implementing the techniques described herein, accordingto at least one example.

DETAILED DESCRIPTION

In the following description, various examples will be described. Forpurposes of explanation, specific configurations and details are setforth in order to provide a thorough understanding of the examples.However, it will also be apparent to one skilled in the art that theexamples may be practiced without the specific details. Furthermore,well-known features may be omitted or simplified in order not to obscurethe example being described.

Examples of the present disclosure are directed to, among other things,methods, systems, devices, and computer-readable media for efficientlyand effectively onboarding health institutions to a provider cloud. Inparticular, instead of requiring every health institution to arduouslyprovide technical information about its EHR system, the techniquesdescribed herein rely on technical information previously gathered fromcommercial EHR vendors to onboard health institutions. This approach isbased on the fact that most health institutions use one or morecommercial EHR vendor products and, for the most part, the form of thetechnical configuration data for each vendor's EHR product will be thesame irrespective of the health institution that is being onboarded.Thus, the health institution need only supply information about itsgateway (e.g., type and version of EHR system) and the system describedherein is able to access the relevant configuration data (e.g., in theform of a conformance statement), perform configuration tests, andperfect the onboarding process with little to no additional burden onthe health institution administrators.

The provider cloud allows users to search for relevant healthinstitutions and download, to their smartphones or other user devices,their respective electronic health records from the health institutions.In some examples, this connection may represent a data pipelineconnection with the health institution. The provider cloud operates asan intermediary between user devices and gateways of the EHR systems.The gateways are effectively outlets or endpoints provided by the EHRsystems. These endpoints are accessible for downloading data from theEHR systems. The techniques described herein efficiently onboard thegateways, test the gateways, and ensure that quality data connectionsare possible with the gateways.

The EHR systems may be configured differently from one another. Forexample, data storage formats, user and administrator functionality, andcoding schemas may be unique to each. A purpose of the provider clouddescribed herein is to enable individual, ongoing data pipelines to beestablished with each of these disparate sources. Once a pipeline isconnected, the provider cloud provides a platform for normalizing thedata storage formats, user and administrator functionality, and codingschemas from these disparate sources. Thus, once each pipeline has beenconnected, the data may be stored on a user device in a uniform format,with a predefined set of user functionality, and according to a singlecoding schema. Doing so results in not only a technical improvement to acomputing device, but does so in a way that stores data from thedisparate sources in an optimized manner. The data is optimized as tostorage capacity and storage access. Because of this, the computingdevice operates more efficiently than other devices that accesselectronic health records. This effectively frees up other computingresources for performing other processes.

Generally, the provider cloud enables a process for onboarding newhealth institutions such that user devices can establish connections totheir EHR systems. The gateways share electronic health records with theuser devices using an industry standard format such as Fast HealthcareInteroperability Resources (FHIR) created by the Health Level Seven(HL7®) International standards organization.

Turning now to the figures, FIG. 1 illustrates a block diagram 102 and aflowchart showing a process 100 for onboarding a health institution to aprovider cloud using a conformance statement, according to at least oneexample. The diagram 102 includes patient user device 104 p, which canbe any suitable electronic user device capable of communicating withother electronic devices or systems over a network such as the Internet.In some examples, the user device 104 p can be a smartphone or otheruser device on which specialized applications can operate. The userdevice 104 p is associated with or otherwise operated by a user 106 p.The user 106 p is an example of a patient whose electronic healthrecords are the subject of this specification.

The diagram 102 also includes a vendor user device 104 v. The vendoruser device 104 v can be any suitable electronic user device capable ofcommunicating with other electronic devices or systems over a networksuch as the Internet. In some examples, the vendor user device 104 v canbe a laptop, personal computer, or other user device on which a vendoruser 106 v may interact. The vendor user 106 v is an example of arepresentative of a commercial EHR vendor (e.g., an administrator).Examples of commercial EHR vendors include companies such as Cerner,Epic, Meditech, and other such companies that provide applications forstoring health records and, in some examples, operating a healthinstitution. The vendor user 106 v uses the vendor user device 104 v tointeract with a provider cloud 112. The provider cloud 112 is used toonboard and manage which entities such as health institutions, EHRsystems, and other such entities can be accessed for downloading EHRdata for patients. For example, the provider cloud 112 onboardsdifferent types and versions of EHR products so that configurationdetails for the EHR products are made available by the provider cloud112. The provider cloud 112 also functions to enable users such as thepatient user 106 p to subscribe to particular entities to createpipelines for downloading EHR data for the patient user 106 p.

The diagram 102 also includes a health institution user 106 h who usesthe health institution user device 104 h to interact with the providercloud 112. For example, the health institution user 106 h may use thehealth institution user device 104 h to subscribe the health an EHRsystem of the health institution to the provider cloud 112.

Medical information associated with the health institution (e.g.,electronic health records of patients of the health institution) isstored at one or more EHR system(s) 114. The EHR system 114 may beassociated with one or more health institutions (e.g., organizationentities, brand entities, and/or location entities). In particular, theEHR system 114 may store, organize, and/or otherwise manage healthrecord data generated by medical professionals of the healthinstitutions. The EHR system 114 includes one or more gateways, eachincluding one or more endpoints to enable multiple connections betweenthe EHR system 114 and other electronic devices. In some examples, userdevices such as the patient user device 104 p may interact with the EHRsystem 114 using any suitable interfaces such as gateway applicationprogramming interfaces (API). The gateway APIs may define a set offunction calls for communications between the EHR system 114 and theuser device 104 p.

FIGS. 1 and 9 illustrate example flow diagrams showing processes 100 and900, according to at least a few examples. These processes, and anyother processes described herein, are illustrated as logical flowdiagrams, each operation of which represents a sequence of operationsthat can be implemented in hardware, computer instructions, or acombination thereof. In the context of computer instructions, theoperations may represent computer-executable instructions stored on oneor more non-transitory computer-readable storage media that, whenexecuted by one or more processors, perform the recited operations.Generally, computer-executable instructions include routines, programs,objects, components, data structures and the like that performparticular functions or implement particular data types. The order inwhich the operations are described is not intended to be construed as alimitation, and any number of the described operations can be combinedin any order and/or in parallel to implement the processes.

Additionally, some, any, or all of the processes described herein may beperformed under the control of one or more computer systems configuredwith specific executable instructions and may be implemented as code(e.g., executable instructions, one or more computer programs, or one ormore applications) executing collectively on one or more processors, byhardware, or combinations thereof. As noted above, the code may bestored on a non-transitory computer-readable storage medium, forexample, in the form of a computer program including a plurality ofinstructions executable by one or more processors.

The process 100 begins at 108 by onboarding a commercial EHR. Theprovider cloud 112 performs 108 based on information received from thevendor user device 104 v. For example, the vendor user 106 v may use thevendor user device 104 v to provider configuration data (e.g.,authentication, tokens, resources addresses) to the provider cloud 112responsive to a set of prompts generated by the provider cloud 112. Insome examples, the set of prompts are included in a form-fillablewebpage provided at the vendor user device 104 v. At 108, the vendoruser 106 v may provide configuration data for each commercial EHR systemoffered by the commercial vendor. This can include multiple versions ofthe commercial EHR system, custom builds of the EHR system for certaincustomers, and the like. In this manner, the provider cloud 112 willinclude configuration data for multiple commercial EHR systems. Theconfiguration data includes, in some examples, standard addresses forpatient record servers, communication protocols used for communicatingwith the commercial EHR system, authentication protocols, web addressesfor particular services, and the like. At 108, the process 100 alsoincludes storing the configuration data for the commercial EHR systemwithin a provider database 110.

At 116, the process 100 includes receiving a gateway identifier for ahealth institution 111 using the commercial EHR system 114. The providercloud 112 performs 116. For example, the health institution users 106 hmay use the health institution user devices 104 h to share informationabout the health institution 111 with the provider cloud 112. Thegateway identifier refers to a network address of an endpoint of the EHRsystem 114 used by the health institution 111. The endpoint is aconnection point of the EHR system 114 that enables sharing of patientrecord data stored by the EHR system 114. The gateway identifier maytake any suitable format such as a path, a uniform resource locator(URL), or other such manner for representing the network address. Insome examples, the gateway identifier is referred to as a FHIR base URL.

In some examples, the health institution user 106 h may easily providerthe gateway identifier using a user interface provided by the providercloud 112. For example, the health institution user 106 h may use thehealth institution user device 104 h to navigate to a webpage associatedwith the provider cloud 112 and there input the gateway identifier. Aspart of inputting this data, the health institution user 106 h mayidentify the type and version of EHR system 114 used by the healthinstitution 111. For example, the user 106 h may designate that thehealth institution 111 uses “Best EHR Storage” system, version 2.1.3.Based on the gateway identifier and, in some examples, the type andversion information, the provider cloud 112 relies on a record in thedatabase 110 created at 108 for continuing the onboarding process forthe health institution 111, instead of requesting additional informationfrom the health institution user 106 h. In some examples, resolving thegateway identifier enables the provider cloud 112 to determine the typeand version of EHR system 114 used by the health institution 111.

At 118, the process 100 includes accessing a conformance statement forthe identified gateway of the health institution 111. This is performedby the provider cloud 112. For example, the provider cloud 112 may usethe gateway identifier to access the gateway of the EHR system 114 andobtain the conformance statement from the EHR system 114 used by thehealth institution 111. In some examples, the conformance statementdefines a set of capabilities and characteristics of the gateway of theEHR system 114. It may be used as a statement of the actualfunctionality of the underlying server(s) that make up the EHR system114 and are available via the gateway. The conformance statementessentially provides the know-how for interacting with the EHR system114. In this manner, the conformance statement can be used in place ofobtaining technical configuration details from the health institutionuser 106 h. In some examples, the conformance statement is an example ofa “capability statement” as used in Fast Healthcare InteroperabilityResources (FHIR®) STU-3 and later.

At 120, the process 100 includes using the conformance statement togenerate a gateway schema for the identified gateway of the healthinstitution 111. This is performed by the provider cloud 112. In someexamples, block 122 is conditional on the gateway passing the test atblock 120. The schema may include at least a portion of the conformancestatement information and other information discovered, generated, orotherwise obtained during the testing at block 120. In particular,generating the schema may include validating the information duringtesting at block 120 and parsing the conformance statement into theschema that is specific to the gateway of the health institution 111.

At 122, the process 100 includes testing the identified gateway of thehealth institution 111 using the gateway schema. This is performed bythe provider cloud 112. In some examples, the testing involves testingthe set of capabilities and confirming the characteristics of thegateway. Testing can include testing against an industry standardspecification for sharing health data such as the FHIR standard. Testingcan also include testing against one or more other specifications suchas one created by an operator of the provider cloud 112. While the FHIRstandard may identify general standards for sharing health data, theoperator-created standard may define specific standards to ensure aconsistent user experience for users who download their medical recordsfrom the EHR system 114 (e.g., the patient user 106 p).

In some examples, the testing occurs with respect to a testing gateway.In this manner, errors identified during testing can be rectified beforeproduction gateway is made available for user connections. The testingcan include simulating a user connection to the gateway and downloadinga patient health record.

At 124, the process 100 includes enabling a user device to connect tothe identified gateway (e.g., the gateway of the EHR system 114) of thehealth institution 111 using the gateway schema generated at block 122.This is performed by the provider cloud 112. For example, the patientuser device 104 p may connect to the EHR system 114 using the gatewayschema, which may be shared with the patient user device 104 p by theprovider cloud 112 when the user device 104 p first attempts to connectto the gateway of the EHR system 114. Downloading health record data mayinclude downloading electronic health records using the FHIR standard.In some examples, the patient user device 104 may connect to anddownload from more than one EHR system 114.

FIG. 2 illustrates a block diagram showing an example architecture orsystem 200 for onboarding a health institution to a provider cloud usinga conformance statement, according to at least one example. The system200 includes a few elements introduced in FIG. 1. In particular, thesystem 200 includes the provider cloud 112, one or more user devices 104a-104 n, and one or more EHR systems 114 a-114 n associated with one ormore health institutions 111 a-111 n. The provider cloud 1112 alsoincludes a business registration system 206 and a queue 214. Asappropriate and as illustrated by the arrows, the elements of the system200 may be communicatively coupled via one or more networks.

Beginning with the business registration system 206, the businessregistration system 206 may be any suitable collection of hardware andsoftware components configured to collect, store, update, and otherwisemanage business locations including those of the health institutions111. For example, the business registration system 206 may include abusiness database 208 and a registration service 210 to enablesubscription of the health institution 111. When health institution 111is subscribed and active, the user devices 104 may be allowed to connectto and download health record data from the associated EHR system 114(e.g., a gateway of the EHR system 114).

As part of subscribing and managing subscriptions, the registrationservice 210 may include functionality to collect, store, update, andotherwise manage business locations. In some examples, the registrationservice 210 provides one or more user interfaces by which authorizedusers may input information about their location. This information mayinclude geographic information (e.g., a physical address and pin on amap), image information (e.g., logos), contact information (e.g.,business, legal, technical, etc.), and any other information relating toa business. The registration service 210 may also be configured tocreate and/or update record entries in the business database 208 basedon information received. For example, an authorized user associated withthe health institution 111 may share business information with thebusiness registration system 206. Once this information has been sharedand validated, the business information may be published for publicconsumption (e.g., indexed for searching, made available on a mapplatform, shared directly with users, etc.).

The business database 208 may maintain the collected businessinformation and any relationships between entities represented by thebusiness information. In some examples, the business database 208includes some or all of the information stored in the provider database110. For example, because the business registration system 206 may beused to register all business (not just health institutions 111),records for the health institutions 111 may be maintained in both thebusiness database 208 and the provider database 110. In some examples,the business registration system 206 shares business information withthe provider cloud 112 in any suitable manner.

Turning now to the provider cloud 112, the provider cloud 112 mayinclude the provider database 110 introduced herein, a provider service209, and a test harness 211. Generally, the provider cloud 112 mayvalidate the EHR systems 114, maintain information about the healthinstitutions 111 and associated EHR systems 114, enable searching of thehealth institutions 111 associated with the EHR systems 114, and manageaccess of the user devices 104 to the EHR systems 114.

After a health institution 111 associated with an EHR system 114 hasbeen subscribed, the test harness 211 of the provider cloud 112 may beused to test and/or otherwise validate that the EHR system 114 meetscertain standards associated with sharing health data. In some examples,the testing may be based, at least in part, on a conformance statementassociated with the EHR system 114.

The testing can include simulating that a test user using a test userdevice 104 can connect to and download data from the EHR system 114. Inthis manner, the test harness 211 may simulate actions that one of theuser devices 104 may perform to connect to the EHR system 114. In someexamples, the test harness 211 may test this connection when a healthinstitution 111 is first subscribed and at other times after the initialsubscription. For example, the connection may be tested periodically,when certain conditions are fulfilled, and under any other circumstance.If the test is positive, a status indicator(s) in the provider database110 associated with the health institution 111, the EHR system 114,and/or a gateway associated with the EHR system 114 may be updated toreflect that the EHR system 114 or the gateway is/are active. If thetest is negative, the status indicator(s) may be updated to reflect thatthe EHR system 114 is inactive. When active, the user devices 104 may becapable of connecting to the gateways of the EHR systems 114. Wheninactive, the user devices 104 may be unable to connect to the gatewaysof the EHR systems 114.

The provider service 209 may maintain information about the healthinstitutions 111 and associated EHR systems 114 in the provider database110, enable searching of the health institutions 111 associated with theEHR systems 114, and manage access of the user devices 104 to the EHRsystems 114. In some examples, the user devices 104 send requests tosearch for the health institutions 111 to the provider service 209. Theprovider service 209 processes these requests and returns results. Insome examples, as part of establishing a connection with one of the EHRsystems 114, the user device 104 will check in with the provider service209 to determine whether any configuration information, which may besaved as a gateway schema, associated with the EHR system 114 haschanged. The gateway schema, which may be stored in the providerdatabase 110 may include API information, provider identifiers, statusindicator information, and any other suitable information relating tothe configuration of the EHR system 114 and/or other entities associatedwith the EHR system 114.

The user devices 104 may include a health application 212. Generally,the user devices 104 may be associated with and operated by differentusers (e.g., patients of the health institutions 111, employees of thehealth institutions 111). Functionally, the health application 212 mayenable the user devices 104 to communicate with the provider cloud 112(e.g., to search for the health institutions 111, obtain configurationinformation about the health institutions 111, and perform otheractions), and communicate with the EHR systems 114 of the healthinstitutions 111 (e.g., to download data packages including electronichealth records and/or updates to electronic health records and toperform other such techniques).

The queue 214 is configured to broker messages between the healthinstitutions 111, the provider cloud 112, and the user devices 104. Insome examples, the queue 214 receives requests from producer entitiesand enables delivery to consumer entities. In some examples, the queue214 is used to receive requests and pass them directly the otherentities, to schedule certain actions, and the like. The queue 214 isconfigured to provide a unified, high-throughput, low-latency platformfor handling real-time data feeds. In some examples, a storage layer ofthe queue 214 may include a scalable pub/sub message queue designed as adistributed transaction log. In some examples, the queue 214 connects toexternal systems (for data import/export) via a connect application andprovides data streaming using a stream processing library. In someexamples, the queue 214 is built on the Apache Kafka platform.

FIG. 3 illustrates a data flow 300 for onboarding a health institutionincluding a custom electronic health record system to a provider cloudusing a conformance statement, according to at least one example. Theflow 300 is performed by the business registration system 206, the queue214, the provider cloud 112, and a database 216. The database 216 mayinclude a distributed, wide column store, NoSQL database managementsystem designed to handle large amounts of data across many commodityservers. Such an arrangement may provide high availability with nosingle point of failure. In some examples, the database 216 providesrobust support for clusters spanning multiple datacenters, withasynchronous masterless replication allowing low latency operations forall clients. In some examples, the database 216 is built on the ApacheCassandra platform.

The data flow 300 begins at (1) by the business registration system 206sending a message to the queue 214 to validate conformance of aconformance statement of a gateway. In some examples, prior to the dataflow 300 beginning at (1), the conformance statement is accessed fromthe gateway of a health institution or provided to the businessregistration system 206 in some other manner. In any event, at (1) thedata flow 300 also includes the test harness 211 validating theconformance statement, which can include validating a gateway identifierfor the gateway, validating a gateway version, and validating an addressassociated with the gateway (e.g., a FHIR-based URL).

At (2), the data flow 300 includes the test harness 211 sharing theresults of the conformance test with the queue 214, which are thenshared with the business registration system 206.

At (3), the data flow 300 includes the business registration system 206sending a message to the queue 214 to update the gateway. This caninclude a message to update a client identifier, a client secret, ascope associated with the conformance statement, a base address for thegateway (e.g., base URL), and a version identifier. Also at (3), thedata flow includes the queue 214 sending a message to the providerservice 209 to update the gateway the information identified previously.At (3), the status of the gateway may be unpublished, e.g., unavailable,when searched by a user device. In some examples, the testing isperformed on a test gateway within a sandbox environment.

Updating the gateway can include, at (4), updating versions of objectsfor the conformance statement stored in the database 216 and/or updatingauthorization information versions stored in the database 216. Theseupdating steps may correspond to the client identifier, the clientsecret, the scope associated with the conformance statement, the baseaddress for the gateway (e.g., base URL), and the version identifier.

At (5), the data flow 300 includes the business registration system 206sending a message to the queue 214 to run a gateway test. In someexamples, the queue 214 passes the message to the test harness 211 ofthe provider cloud 112 to perform the gateway test. The gateway test caninclude the test harness 211 performing one or more configuration testsusing the conformance statement. For example, the test harness 211 cantest links to patient record servers identified in the conformancestatement, download test patient data, simulate a user device connectionto the provider cloud 112, simulate a download of test patient data fromthe gateway, and confirm that the downloaded data corresponds to one ormore standards.

Testing the gateway can include, at (6) and (7) accessing object versioninformation from the database 216 and testing the gateway schema and thegateway schema versions. These testing steps may correspond to the testharness 211 performing the configuration test described previously.

At (8), the data flow 300 includes sharing the gateway test results withthe business registration system 206 via the queue 214, at (9). Once thebusiness registration system 206 has the results, it can again begin theprocess of updating the gateway, which includes (10), (11), and (12). Insome examples, the updating at (10) may include updating at least someof same data elements updated at (3). However, the update at (10) mayresult in the status of the gateway changing from not published topublished. This may make the gateway a production gateway.

FIG. 4 illustrates a data flow 400 for onboarding a health institutionincluding a custom electronic health record system to a provider cloudusing a conformance statement, according to at least one example. Theflow 400 is performed by the business registration system 206, the queue214, the provider cloud 112, and the database 216.

The data flow 400 begins at (1) by the business registration system 206sending a message to the queue 214 to validate conformance of aconformance statement of a gateway. In some examples, prior to the dataflow 300 beginning at (1), the conformance statement is accessed fromthe gateway of a health institution or provided to the businessregistration system 206 in some other manner. In any event, at (2) thedata flow 300 also includes the test harness 211 validating theconformance statement, which can include validating a gateway identifierfor the gateway, validating a gateway version, and validating an addressassociated with the gateway (e.g., a FHIR-based URL).

At (3) and (4), the data flow 400 includes the business registrationsystem 206 receiving, via the queue 214, the results of the conformancestatement validation performed at (2).

At (5), the data flow 400 includes the business registration system 206sending message to the queue 214 to update the gateway. This can includea message to update a client identifier, a client secret, a scopeassociated with the conformance statement, a base address for thegateway (e.g., base URL), and a version identifier. At (6), the dataflow 400 includes the queue 214 sending a message to the providerservice 209 to update the gateway information identified previously. At(5), the status of the gateway may be unpublished, e.g., unavailablewhen searched by a user device. In some examples, the testing isperformed on a test gateway within a sandbox environment.

Updating the gateway can include, at (7), updating versions of objectsfor the conformance statement stored in the database 216 and/or updatingauthorization information versions stored in the database 216. Theseupdating steps may correspond to the client identifier, the clientsecret, the scope associated with the conformance statement, the baseaddress for the gateway (e.g., base URL), and the version identifier.

At (8), the data flow 400 includes the business registration system 206sending a message to the queue 214 to run a gateway test. In someexamples, this message includes an authorization code. In some examples,at (9), the queue 214 passes the message, which may include theauthorization code, to the test harness 211 of the provider cloud 112 toperform the gateway test. The gateway test can include the test harness211 performing one or more configuration tests using the conformancestatement. For example, the test harness 211 can test links to patientrecord servers identified in the conformance statement, download testpatient data, simulate a user device connection to the provider cloud112, simulate a download of test patient data from the gateway, andconfirm that the downloaded data corresponds to one or more standards.

Testing the gateway can include, at (10), accessing object versioninformation, authorization information including testing an applicationprogramming interface to a database (e.g., “data scripts API”), and EHRsystem authorization information including testing a custom gateway fromthe database 216 and testing the gateway schema versions at (11) and thegateway schema at (12). These testing steps may correspond to the testharness 211 performing the configuration test described previously.

At (13), the data flow 400 includes sharing the gateway test resultswith the queue 214, which in turns shares the results with the businessregistration system 206, at (14). Once the business registration system206 has the results, it can again begin the process of updating thegateway, which includes (15) and (16) using the provider service 209. Insome examples, the updating at (15) may include updating at least someof same data elements updated at (6). However, the update at (15) mayresult in the status of the gateway changing from not published topublished. This may make the gateway a production gateway. In someexamples, at (17), the data flow 400 includes designating the gateway asa supported EHR system.

FIG. 5 illustrates a data flow 500 for creating a gateway schema forgateway of a health institution, according to at least one example. Thedata flow 500 is performed by the business registration system 206, thequeue 214, the provider cloud 112, the database 216.

The data flow 500 begins at (1), by the business registration system 206requesting the test harness 211 to perform a gateway test. The gatewaytest can perform as described herein. At (2), the data flow 500 includesthe test harness 211 accessing gateway information from the database216. Such information may include version information for the gatewayschema. If the gateway passes the gateway test, then, at (3), thegateway schema is generated. Additionally, at (4), a message is sent tothe business registration system 2106 indicating that the test wassuccessful. At (5), the gateway is published to the provider service 209(e.g., made available within the provider database 110.

Periodic testing of the gateway can be scheduled at (6). Then thetesting can be performed at (7) and (8), which correspond to (2) and(3). If the gateway passes again, it will remain available at theprovider service 209. If not, the gateway will be removed from a list ofsupported gateways, as described with reference to FIG. 7.

FIG. 6 illustrates a user interface 600 for obtaining configuration datafor a gateway of a health institution, according to at least oneexample. The user interface 600 can be presented at by the providercloud 112 at one of the user devices 104 (e.g., a health institutionuser device 104 h or a vendor user device 104 v). The user interface 600includes an endpoint/gateway configuration area 602. In the endpointconfiguration area 602 is presented one or more text input boxes inwhich can be input configuration data for configuring a gateway. Theconfiguration data includes, for example, an authorization URL, a FHIRresource URL, and a token URL.

FIG. 7 illustrates a user interface 700 for obtaining configuration datafor a gateway of a health institution, according to at least oneexample. The user interface 700 can be presented at by the providercloud 112 at one of the user devices 104 (e.g., a health institutionuser device 104 h or a vendor user device 104 v). The user interface 700includes an endpoint/gateway configuration area 702. In the endpointconfiguration area 702 is presented one or more text input boxes inwhich can be input data for configuring a gateway. The configurationdata includes, for example, a FHIR base URL. The FHIR base URL functionsas a gateway identifier. Using the FHIR base URL, the systems describedherein can access the conformance statement that includes, among otherthings, similar configuration data as shown in the endpointconfiguration area 602.

FIG. 8 illustrates a user interface 800 for presenting a list ofsupported gateways, according to at least one example. The userinterface 800 can be presented by the provider cloud 112 at one of theuser devices (e.g., the patient user device 104 p). The user interface800 includes a supported gateways area 802. In the supported gatewaysarea 802 is presented a list of supported gateways. In some examples,the list of supported gateways may identify the health institution andwhich EHR system and version are used by each health institution. Insome examples, a similar list, but without the health institution name,can be presented at the health institution user device 104 h. This maybe desirable for the health institution user 106 h to select which EHRsystem and version the health institution operates. Using this approachmay allow the health institution user 106 h to quickly and efficientlyonboard the gateway of their health institution because much of theconfiguring has already been performed. In particular, the EHR systemand versions have been configured, e.g., by the vendor user 106 v, andthe health institution user 106 h just needs to identify the gatewayaddress and the process can automatically validate the gateway of thehealth institution as described herein.

FIG. 9 illustrates an example flow chart showing a process 900 foronboarding a health institution to a provider cloud using a conformancestatement, according to at least one example. The process 900 begins at902 by receiving a gateway identifier corresponding to a patient recordgateway (e.g., a gateway of an EHR system such as the EHR system 114(FIG. 1)). This may be performed by the provider service 209 (FIG. 2) ofthe provider cloud 112 (FIG. 1). In some examples, the gatewayidentifier is a FHIR base URL associated with the gateway. The gatewayidentifier may be received via an interface such as the user interface700 configured to receive the gateway identifier. The patient recordgateway may be associated with one or more patient record serversconfigured for storing electronic health records for a plurality ofpatients. In some examples, the one or more patient record servers arefurther configured for outputting electronic health record informationin accordance with one or more predefined standards. The one or morepredefined standards may include the Fast Healthcare InteroperabilityResources (FHIR®) standard. The patient record servers may make up theEHR system 114 described herein. The patient record servers may behosted by a third-party such as the health institutions or a vendor.

At 904, the process 900 includes accessing a gateway conformancestatement. This may be performed by the test harness 211 (FIG. 2) of theprovider cloud 112. In some examples, accessing the gateway conformancestatement may be based at least in part on identifying informationassociated with the patient record gateway. For example, the identifyinginformation may be the gateway identifier (e.g., a FHIR base URL) orother identifying information such as an address of a location at theEHR system where the conformance statement is stored other than at theFHIR base URL. The gateway conformance statement may definecharacteristics and capabilities of the one or more patient recordservers.

In some examples, the characteristics of the conformance statementinclude an authorization Uniform Resource Locator (URL), a token URL, aresource URL, a first list of supported resources, a second list ofsupported search parameters, and types of supported interaction.

In some examples, accessing the gateway conformance statement mayinclude requesting the gateway conformance statement from the patientrecord gateway and receiving the gateway conformance statement from thepatient record gateway.

At 906, the process 900 includes performing a configuration test of thepatient record gateway. This may be performed by the test harness 211 ofthe provider cloud 112. In some examples, performing the configurationtest includes testing a plurality of capabilities of the patient recordgateway using the gateway conformance statement and a set of testpatient credentials. The test patient credentials may be obtained fromthe EHR system and/or provided by an administrator of the healthinstitution or vendor that is participating in the onboarding process.The gateway configuration test can include verifying connectivity of oneor more patient record servers of the patient record gateway based atleast in part on the gateway conformance statement and verifyingconformance of the patient record gateway with one or more predefinedstandards for patient record storage and transmission based at least inpart on the gateway conformance statement. The gateway configurationtest can also include identifying one or more resources associated withthe patient record gateway based at least in part on the gatewayconformance statement. The one or resources may be available at the oneor more patient record servers of the patient record gateway. Thegateway configuration test can also include parsing the gatewayconformance statement to create one or more gateway schemas foraccessing patient record data from the one or more patient recordservers, accessing the one or more patient record servers to obtain testpatient record data in accordance with the one or more gateway schemas,comparing the test patient data obtained from the one or more patientrecord servers with a user data standard specification for patientrecord storage on a user device, and simulating authorization of a userdevice by the patient record gateway based at least in part on a set oftest patient credentials.

In some examples, performing the configuration test of the plurality ofcapabilities includes instructing a test harness to perform theconfiguration test by simulating authorization of a test patient usingthe set of test patient credentials and simulating retrieval of a testelectronic health record associated with the set of test patientcredentials.

In some examples, performing the configuration test of the one or morecapabilities includes validating the one or more capabilities, andvalidating one or more characteristic of the patient record gateway. Inthis example, the process 900 further includes parsing the gatewayconformance statement based at least in part on results of theconfiguration test, and defining a gateway schema for the patient recordgateway based at least in part on parsing the gateway conformancestatement. The gateway schema may define a protocol for authorization ofa patient and retrieval, by the patient using a user device, of aportion of an electronic health record of the patient that is hosted bythe patient record gateway.

At 908, the process 900 includes determining whether the patient recordgateway passes the configuration test. If the patient record gatewaydoes not pass the configuration test (i.e., the answer at 908 is “No”),the process 900 proceeds to 912, at which a test failure message isgenerated. This may be performed by the provider service 209 or the testharness 211 of the provider cloud 112. The test failure message mayindicate which portions of the test the patient record gateway failed.In some examples, the test failure message may cause the patient recordgateway to change states from available to unavailable. For example,when the configuration test is performed after the patient recordgateway has been published (e.g., the gateway is a production gateway,not a test gateway), failing the configuration test may cause theproduct gateway to be disabled. When disabled, the gateway may beunavailable for selection within the list of supported gateways, asdescribed with reference to FIG. 8.

If the patient record gateway passes the configuration test (i.e., theanswer at 908 is “Yes”), the process 900 proceeds to 910, at which thepatient record gateway is added to a list of supported patient recordgateways. This may be performed by the provider service 209 of theprovider cloud 112. Adding the patient record gateway may include addingthe patient record gateway to the list of supported gateways, asdescribed with reference to FIG. 7.

In some examples, the patient record gateway includes a test version ofthe patient record gateway that operates in a test environment (e.g., asandbox). In this example, adding the patient record gateway to the listof supported patient record gateways may include, in accordance with thedetermination that the test version of the patient record gateway passesthe configuration test, adding a production version of the patientrecord gateway to the list of supported patient record gateways. Passingthe configuration test may include achieving positive results on all ora portion of the test criteria.

In some examples, the process 900 further includes providing a userinterface for presentation at a user device, the user interfaceincluding the list of supported patient record gateways.

In some examples, the patient record gateway is one of a plurality ofpatient record gateways provided by a patient record vendor. In thisexample, each patient record gateway of the plurality of patient recordgateways is associated with a particular gateway conformance statement.

FIG. 10 illustrates an example architecture or environment 1000configured to implement techniques described herein, according to atleast one example. In some examples, the example architecture 1000 mayfurther be configured to enable the user device 104, service providercomputers 1002 to share information. The service provider computers 1002are examples of the business registration system 206, the provider cloud112, and the EHR systems 114. In some examples, the devices may beconnected via one or more networks 1008 (e.g., via Bluetooth, WiFi, theInternet, or the like). In some examples, the service provider computers1002 may be configured to implement at least some of the techniquesdescribed herein with reference to the user device 104.

In some examples, the networks 1008 may include any one or a combinationof many different types of networks, such as cable networks, theInternet, wireless networks, cellular networks, satellite networks,other private and/or public networks, or any combination thereof. Whilethe illustrated example represents the user device 104 accessing theservice provider computers 1002 via the networks 1008, the describedtechniques may equally apply in instances where the user device 104interacts with the service provider computers 1002 over a landlinephone, via a kiosk, or in any other manner. It is also noted that thedescribed techniques may apply in other client/server arrangements(e.g., set-top boxes, etc.), as well as in non-client/serverarrangements (e.g., locally stored applications, peer to peerconfigurations, etc.).

As noted above, the user device 104 may be any type of computing devicesuch as, but not limited to, a mobile phone, a smartphone, a personaldigital assistant (PDA), a laptop computer, a desktop computer, athin-client device, a tablet computer, a wearable device, or the like.In some examples, the user device 104 may be in communication with theservice provider computers 1002 via the network 1008, or via othernetwork connections.

In one illustrative configuration, the user device 104 may include atleast one memory 1014 and one or more processing units (or processor(s))1016. The processor(s) 1016 may be implemented as appropriate inhardware, computer-executable instructions, firmware, or combinationsthereof. Computer-executable instruction or firmware implementations ofthe processor(s) 1016 may include computer-executable ormachine-executable instructions written in any suitable programminglanguage to perform the various functions described. The user device 104may also include geo-location devices (e.g., a global positioning system(GPS) device or the like) for providing and/or recording geographiclocation information associated with the user device 104.

The memory 1014 may store program instructions that are loadable andexecutable on the processor(s) 1016, as well as data generated duringthe execution of these programs. Depending on the configuration and typeof the user device 104, the memory 1014 may be volatile (such as randomaccess memory (RAM)) and/or non-volatile (such as read-only memory(ROM), flash memory, etc.). The user device 104 may also includeadditional removable storage and/or non-removable storage 1026including, but not limited to, magnetic storage, optical disks, and/ortape storage. The disk drives and their associated non-transitorycomputer-readable media may provide non-volatile storage ofcomputer-readable instructions, data structures, program modules, andother data for the computing devices. In some implementations, thememory 1014 may include multiple different types of memory, such asstatic random access memory (SRAM), dynamic random access memory (DRAM),or ROM. While the volatile memory described herein may be referred to asRAM, any volatile memory that would not maintain data stored thereinonce unplugged from a host and/or power would be appropriate.

The memory 1014 and the additional storage 1026, both removable andnon-removable, are all examples of non-transitory computer-readablestorage media. For example, non-transitory computer readable storagemedia may include volatile or non-volatile, removable or non-removablemedia implemented in any method or technology for storage of informationsuch as computer-readable instructions, data structures, programmodules, or other data. The memory 1014 and the additional storage 1026are both examples of non-transitory computer storage media. Additionaltypes of computer storage media that may be present in the user device104 may include, but are not limited to, phase-change RAM (PRAM), SRAM,DRAM, RAM, ROM, Electrically Erasable Programmable Read-Only Memory(EEPROM), flash memory or other memory technology, compact discread-only memory (CD-ROM), digital video disc (DVD) or other opticalstorage, magnetic cassettes, magnetic tape, magnetic disk storage orother magnetic storage devices, or any other medium that can be used tostore the desired information and that can be accessed by the userdevice 104. Combinations of any of the above should also be includedwithin the scope of non-transitory computer-readable storage media.Alternatively, computer-readable communication media may includecomputer-readable instructions, program modules, or other datatransmitted within a data signal, such as a carrier wave, or othertransmission. However, as used herein, computer-readable storage mediadoes not include computer-readable communication media.

The user device 104 may also contain communications connection(s) 1028that allow the user device 104 to communicate with a data store, anothercomputing device or server, user terminals, and/or other devices via thenetwork 1008. The user device 104 may also include I/O device(s) 1030,such as a keyboard, a mouse, a pen, a voice input device, a touch inputdevice, a display, speakers, a printer, etc.

Turning to the contents of the memory 1014 in more detail, the memory1014 may include an operating system 1032 and/or one or more applicationprograms or services for implementing the features disclosed herein suchas a service engine 1003 a. The service provider computer 1002 may alsoinclude a memory 1042 that includes a service engine 1003 b. In thismanner, the techniques described herein may be implemented by any one,or a combination of more than one, of the computing devices (e.g., theuser device 104 or the service provider computer 1002). The serviceengine 1003 may be configured to implement the functions of theregistration service 210, the provider service 209, the test harness211, and any other function of a device or system described herein.

The service provider computers 1002 may also be any type of computingdevice such as, but not limited to, a mobile phone, a smartphone, a PDA,a laptop computer, a desktop computer, a thin-client device, a tabletcomputer, a wearable device, a server computer, a virtual machineinstance, etc. In some examples, the service provider computers 1002 maybe in communication with the user device 104 via the network 1008, orvia other network connections.

In one illustrative configuration, the service provider computers 1002may include at least one memory 1042 and one or more processing units(or processor(s)) 1044. The processor(s) 1044 may be implemented asappropriate in hardware, computer-executable instructions, firmware, orcombinations thereof. Computer-executable instruction or firmwareimplementations of the processor(s) 1044 may include computer-executableor machine-executable instructions written in any suitable programminglanguage to perform the various functions described.

The memory 1042 may store program instructions that are loadable andexecutable on the processor(s) 1044, as well as data generated duringthe execution of these programs. Depending on the configuration and typeof service provider computer 1002, the memory 1042 may be volatile (suchas RAM) and/or non-volatile (such as ROM, flash memory, etc.). Theservice provider computer 1002 may also include additional removablestorage and/or non-removable storage 1046 including, but not limited to,magnetic storage, optical disks, and/or tape storage. The disk drivesand their associated non-transitory computer-readable media may providenon-volatile storage of computer-readable instructions, data structures,program modules, and other data for the computing devices. In someimplementations, the memory 1042 may include multiple different types ofmemory, such as SRAM, DRAM, or ROM. While the volatile memory describedherein may be referred to as RAM, any volatile memory that would notmaintain data stored therein once unplugged from a host and/or powerwould be appropriate. The memory 1042 and the additional storage 1046,both removable and non-removable, are both additional examples ofnon-transitory computer-readable storage media.

The service provider computer 1002 may also contain communicationsconnection(s) 1048 that allow the service provider computer 1002 tocommunicate with a data store, another computing device or server, userterminals and/or other devices via the network 1008. The serviceprovider computer 1002 may also include I/O device(s) 1050, such as akeyboard, a mouse, a pen, a voice input device, a touch input device, adisplay, speakers, a printer, etc.

Turning to the contents of the memory 1042 in more detail, the memory1042 may include an operating system 1052 and/or one or more applicationprograms or services for implementing the features disclosed hereinincluding the service engine 1003 b.

Therefore, although the present disclosure broadly covers use ofpersonal information data to implement one or more various disclosedembodiments, the present disclosure also contemplates that the variousembodiments can also be implemented without the need for accessing suchpersonal information data. That is, the various embodiments of thepresent technology are not rendered inoperable due to the lack of all ora portion of such personal information data.

The various examples further can be implemented in a wide variety ofoperating environments, which in some cases can include one or more usercomputers, computing devices or processing devices which can be used tooperate any of a number of applications. User or client devices caninclude any of a number of general purpose personal computers, such asdesktop or laptop computers running a standard operating system, as wellas cellular, wireless and handheld devices running mobile software andcapable of supporting a number of networking and messaging protocols.Such a system also can include a number of workstations running any of avariety of commercially-available operating systems and other knownapplications for purposes such as development and database management.These devices also can include other electronic devices, such as dummyterminals, thin-clients, gaming systems, and other devices capable ofcommunicating via a network.

Most examples utilize at least one network that would be familiar tothose skilled in the art for supporting communications using any of avariety of commercially-available protocols, such as TCP/IP, OSI, FTP,UPnP, NFS, CIFS, and AppleTalk. The network can be, for example, a localarea network, a wide-area network, a virtual private network, theInternet, an intranet, an extranet, a public switched telephone network,an infrared network, a wireless network, and any combination thereof.

In examples utilizing a network server, the network server can run anyof a variety of server or mid-tier applications, including HTTP servers,FTP servers, CGI servers, data servers, Java servers, and businessapplication servers. The server(s) may also be capable of executingprograms or scripts in response to requests from user devices, such asby executing one or more applications that may be implemented as one ormore scripts or programs written in any programming language, such asJava®, C, C#or C++, or any scripting language, such as Perl, Python orTCL, as well as combinations thereof. The server(s) may also includedatabase servers, including without limitation those commerciallyavailable from Oracle®, Microsoft®, Sybase®' and IBM®.

The environment can include a variety of data stores and other memoryand storage media as discussed above. These can reside in a variety oflocations, such as on a storage medium local to (and/or resident in) oneor more of the computers or remote from any or all of the computersacross the network. In a particular set of examples, the information mayreside in a storage-area network (SAN) familiar to those skilled in theart. Similarly, any necessary files for performing the functionsattributed to the computers, servers or other network devices may bestored locally and/or remotely, as appropriate. Where a system includescomputerized devices, each such device can include hardware elementsthat may be electrically coupled via a bus, the elements including, forexample, at least one central processing unit (CPU), at least one inputdevice (e.g., a mouse, keyboard, controller, touch screen, or keypad),and at least one output device (e.g., a display device, printer, orspeaker). Such a system may also include one or more storage devices,such as disk drives, optical storage devices, and solid-state storagedevices such as RAM or ROM, as well as removable media devices, memorycards, flash cards, etc.

Such devices also can include a computer-readable storage media reader,a communications device (e.g., a modem, a network card (wireless orwired), an infrared communication device, etc.), and working memory asdescribed above. The computer-readable storage media reader can beconnected with, or configured to receive, a non-transitorycomputer-readable storage medium, representing remote, local, fixed,and/or removable storage devices as well as storage media fortemporarily and/or more permanently containing, storing, transmitting,and retrieving computer-readable information. The system and variousdevices also typically will include a number of software applications,modules, services, or other elements located within at least one workingmemory device, including an operating system and application programs,such as a client application or browser. It should be appreciated thatalternate examples may have numerous variations from that describedabove. For example, customized hardware might also be used and/orparticular elements might be implemented in hardware, software(including portable software, such as applets) or both. Further,connection to other computing devices such as network input/outputdevices may be employed.

Non-transitory storage media and computer-readable media for containingcode, or portions of code, can include any appropriate media known orused in the art, including storage media, such as, but not limited to,volatile and non-volatile, removable and non-removable media implementedin any method or technology for storage of information such ascomputer-readable instructions, data structures, program modules, orother data, including RAM, ROM, EEPROM, flash memory or other memorytechnology, CD-ROM, DVD or other optical storage, magnetic cassettes,magnetic tape, magnetic disk storage or other magnetic storage devices,or any other medium which can be used to store the desired informationand which can be accessed by a system device. Based at least in part onthe disclosure and teachings provided herein, a person of ordinary skillin the art will appreciate other ways and/or methods to implement thevarious examples.

The specification and drawings are, accordingly, to be regarded in anillustrative rather than a restrictive sense. It will, however, beevident that various modifications and changes may be made thereuntowithout departing from the broader spirit and scope of the disclosure asset forth in the claims.

Other variations are within the spirit of the present disclosure. Thus,while the disclosed techniques are susceptible to various modificationsand alternative constructions, certain illustrated examples thereof areshown in the drawings and have been described above in detail. It shouldbe understood, however, that there is no intention to limit thedisclosure to the specific form or forms disclosed, but on the contrary,the intention is to cover all modifications, alternative constructionsand equivalents falling within the spirit and scope of the disclosure,as defined in the appended claims.

The use of the terms “a” and “an” and “the” and similar referents in thecontext of describing the disclosed examples (especially in the contextof the following claims) are to be construed to cover both the singularand the plural, unless otherwise indicated herein or clearlycontradicted by context. The terms “comprising,” “having,” “including,”and “containing” are to be construed as open-ended terms (e.g., meaning“including, but not limited to,”) unless otherwise noted. The term“connected” is to be construed as partly or wholly contained within,attached to, or joined together, even if there is something intervening.Recitation of ranges of values herein are merely intended to serve as ashorthand method of referring individually to each separate valuefalling within the range, unless otherwise indicated herein, and eachseparate value is incorporated into the specification as if it wereindividually recited herein. All methods described herein can beperformed in any suitable order unless otherwise indicated herein orotherwise clearly contradicted by context. The use of any and allexamples, or exemplary language (e.g., “such as”) provided herein, isintended merely to better illuminate examples of the disclosure and doesnot pose a limitation on the scope of the disclosure unless otherwiseclaimed. No language in the specification should be construed asindicating any non-claimed element as essential to the practice of thedisclosure.

Disjunctive language such as the phrase “at least one of X, Y, or Z,”unless specifically stated otherwise, is otherwise understood within thecontext as used in general to present that an item, term, etc., may beeither X, Y, or Z, or any combination thereof (e.g., X, Y, and/or Z).Thus, such disjunctive language is not generally intended to, and shouldnot, imply that certain examples require at least one of X, at least oneof Y, or at least one of Z to each be present.

Preferred examples of this disclosure are described herein, includingthe best mode known to the inventors for carrying out the disclosure.Variations of those preferred examples may become apparent to those ofordinary skill in the art upon reading the foregoing description. Theinventors expect skilled artisans to employ such variations asappropriate, and the inventors intend for the disclosure to be practicedotherwise than as specifically described herein. Accordingly, thisdisclosure includes all modifications and equivalents of the subjectmatter recited in the claims appended hereto as permitted by applicablelaw. Moreover, any combination of the above-described elements in allpossible variations thereof is encompassed by the disclosure unlessotherwise indicated herein or otherwise clearly contradicted by context.

All references, including publications, patent applications, andpatents, cited herein are hereby incorporated by reference to the sameextent as if each reference were individually and specifically indicatedto be incorporated by reference and were set forth in its entiretyherein.

As described above, one aspect of the present technology is thegathering and use of data available from various sources to provide acomprehensive and complete window to a user's personal health record.The present disclosure contemplates that in some instances, thisgathered data may include personally identifiable information (PII) datathat uniquely identifies or can be used to contact or locate a specificperson. Such personal information data can include demographic data,location-based data, telephone numbers, email addresses, Twitter ID's,home addresses, data or records relating to a user's health or level offitness (e.g., vital sign measurements, medication information, exerciseinformation), date of birth, or any other identifying or personal orhealth information.

The present disclosure recognizes that the use of such personalinformation data, in the present technology, can be used to the benefitof users. For example, the personal information data can be used toprovide enhancements to a user's personal health record. Further, otheruses for personal information data that benefit the user are alsocontemplated by the present disclosure. For instance, health and fitnessdata may be used to provide insights into a user's general wellness, ormay be used as positive feedback to individuals using technology topursue wellness goals.

The present disclosure contemplates that the entities responsible forthe collection, analysis, disclosure, transfer, storage, or other use ofsuch personal information data will comply with well-established privacypolicies and/or privacy practices. In particular, such entities shouldimplement and consistently use privacy policies and practices that aregenerally recognized as meeting or exceeding industry or governmentalrequirements for maintaining personal information data private andsecure. Such policies should be easily accessible by users, and shouldbe updated as the collection and/or use of data changes. Personalinformation from users should be collected for legitimate and reasonableuses of the entity and not shared or sold outside of those legitimateuses. Further, such collection/sharing should occur after receiving theinformed consent of the users. Additionally, such entities shouldconsider taking any needed steps for safeguarding and securing access tosuch personal information data and ensuring that others with access tothe personal information data adhere to their privacy policies andprocedures. Further, such entities can subject themselves to evaluationby third parties to certify their adherence to widely accepted privacypolicies and practices. In addition, policies and practices should beadapted for the particular types of personal information data beingcollected and/or accessed and adapted to applicable laws and standards,including jurisdiction-specific considerations. For instance, in the US,collection of or access to certain health data may be governed byfederal and/or state laws, such as the Health Insurance Portability andAccountability Act (HIPAA); whereas health data in other countries maybe subject to other regulations and policies and should be handledaccordingly. Hence different privacy practices should be maintained fordifferent personal data types in each country.

Despite the foregoing, the present disclosure also contemplatesembodiments in which users selectively block the use of, or access to,personal information data. That is, the present disclosure contemplatesthat hardware and/or software elements can be provided to prevent orblock access to such personal information data. For example, in the caseof advertisement delivery services or other services relating to healthrecord management, the present technology can be configured to allowusers to select to “opt in” or “opt out” of participation in thecollection of personal information data during registration for servicesor anytime thereafter. In addition to providing “opt in” and “opt out”options, the present disclosure contemplates providing notificationsrelating to the access or use of personal information. For instance, auser may be notified upon downloading an app that their personalinformation data will be accessed and then reminded again just beforepersonal information data is accessed by the app.

Moreover, it is the intent of the present disclosure that personalinformation data should be managed and handled in a way to minimizerisks of unintentional or unauthorized access or use. Risk can beminimized by limiting the collection of data and deleting data once itis no longer needed. In addition, and when applicable, including incertain health related applications, data de-identification can be usedto protect a user's privacy. De-identification may be facilitated, whenappropriate, by removing specific identifiers (e.g., date of birth,etc.), controlling the amount or specificity of data stored (e.g.,collecting location data a city level rather than at an address level),controlling how data is stored (e.g., aggregating data across users),and/or other methods.

What is claimed is:
 1. A computer system, comprising: a first userinterface configured to receive a gateway identifier corresponding to apatient record gateway, the patient record gateway associated with oneor more patient record servers configured for storing electronic healthrecords for a plurality of patients; a memory comprisingcomputer-executable instructions that, when executed by a processor,cause the processor to at least: access a gateway conformance statementbased at least in part on identifying information associated with thepatient record gateway, the gateway conformance statement definingcharacteristics and capabilities of the one or more patient recordservers; perform a configuration test of one or more capabilities of thepatient record gateway using the gateway conformance statement and a setof test patient credentials; and in accordance with a determination thatthe patient record gateway passes the configuration test, add thepatient record gateway to a list of supported patient record gateways;and a second user interface configured to present the list of supportedpatient record gateways.
 2. The computer system of claim 1, whereinperforming the configuration test of the one or more capabilitiescomprises: validating one or more capabilities; and validating one ormore characteristic of the patient record gateway.
 3. The computersystem of claim 2, wherein the memory includes additionalcomputer-executable instructions that, when executed by the processor,further cause the processor to at least: parse the gateway conformancestatement based at least in part on results of the configuration test;and define a gateway schema for the patient record gateway based atleast in part on parsing the gateway conformance statement.
 4. Thecomputer system of claim 3, wherein the gateway schema defines aprotocol for authorization of a patient and retrieval, by the patientusing a user device, of a portion of an electronic health record of thepatient that is hosted by the patient record gateway.
 5. The computersystem of claim 1, wherein accessing the gateway conformance statementcomprises requesting the gateway conformance statement from the patientrecord gateway and receiving the gateway conformance statement from thepatient record gateway.
 6. The computer system of claim 1, wherein thepatient record gateway comprises a test version of the patient recordgateway that operates in a test environment.
 7. The computer system ofclaim 6, wherein adding the patient record gateway to the list ofsupported patient record gateways comprises, in accordance with thedetermination that the test version of the patient record gateway passesthe configuration test, adding a production version of the patientrecord gateway to the list of supported patient record gateways.
 8. Acomputer-implemented method, comprising: receiving a gateway identifiercorresponding to a patient record gateway, the patient record gatewayassociated with one or more patient record servers configured forstoring electronic health records for a plurality of patients; accessinga gateway conformance statement based at least in part on identifyinginformation associated with the patient record gateway, the gatewayconformance statement defining characteristics and capabilities of theone or more patient record servers; performing a configuration test of aplurality of capabilities of the patient record gateway using thegateway conformance statement and a set of test patient credentials; andin accordance with a determination that the patient record gatewaypasses the configuration test, adding the patient record gateway to alist of supported patient record gateways.
 9. The computer-implementedmethod of claim 8, wherein performing the configuration test of theplurality of capabilities comprises instructing a test harness toperform the configuration test by simulating authorization of a testpatient using the set of test patient credentials and simulatingretrieval of a test electronic health record associated with the set oftest patient credentials.
 10. The computer-implemented method of claim8, further comprising providing a user interface for presentation at auser device, the user interface comprising the list of supported patientrecord gateways.
 11. The computer-implemented method of claim 8, whereinthe patient record gateway is one of a plurality of patient recordgateways provided by a patient record vendor, each patient recordgateway of the plurality of patient record gateways associated with aparticular gateway conformance statement.
 12. The computer-implementedmethod of claim 8, wherein the one or more patient record servers arefurther configured for outputting electronic health record informationin accordance with one or more predefined standards.
 13. Thecomputer-implemented method of claim 12, wherein the one or morepredefined standards comprises the Fast Healthcare InteroperabilityResources (FHIR®) standard.
 14. The computer-implemented method of claim8, wherein the characteristics of the gateway conformance statementcomprise an authorization Uniform Resource Locator (URL), a token URL, aresource URL, a first list of supported resources, a second list ofsupported search parameters, and types of supported interaction.
 15. Thecomputer-implemented method of claim 8, wherein performing theconfiguration test comprises: verifying connectivity of the one or morepatient record servers of the patient record gateway using the gatewayconformance statement; verifying conformance of the patient recordgateway with one or more predefined standards for patient record storageand transmission based at least in part on the gateway conformancestatement; and simulating authorization of a user device by the patientrecord gateway based at least in part on test patient credentials. 16.The computer-implemented method of claim 8, wherein performing theconfiguration test comprises: identifying one or more resourcesassociated with the patient record gateway based at least in part on thegateway conformance statement, the one or more resources being availableat the one or more patient record servers of the patient record gateway;and parsing the gateway conformance statement to create one or moregateway schemas for accessing patient record data from the one or moreresources.
 17. The computer-implemented method of claim 16, whereinperforming the configuration test further comprises: accessing the oneor more resources to obtain test patient record data in accordance withthe one or more gateway schemas; and comparing the test patient dataobtained from the one or more resources with a user data standardspecification for patient record storage on a user device.
 18. One ormore computer-readable media comprising computer-executable instructionsthat, when executed by one or more computer systems, cause the one ormore computer systems to perform operations, comprising: performing aconfiguration test of a patient record gateway by at least: verifyingconnectivity of one or more patient record servers of the patient recordgateway based at least in part on a gateway conformance statement, thegateway conformance statement defining characteristics and capabilitiesof the one or more patient record servers; verifying conformance of thepatient record gateway with one or more global standards for patientrecord storage and transmission based at least in part on the gatewayconformance statement; identifying one or more resources associated withthe patient record gateway based at least in part on the gatewayconformance statement, the one or more resources being available at theone or more patient record servers of the patient record gateway; andparsing the gateway conformance statement to create one or more gatewayschemas for accessing patient record data from the one or more patientrecord servers; and generating a notification comprising a result of theconfiguration test.
 19. The one or more computer-readable media of claim18, wherein performing the configuration test further comprises:accessing the one or more patient record servers to obtain test patientrecord data in accordance with the one or more gateway schemas; andcomparing the test patient data obtained from the one or more patientrecord servers with a user data standard specification for patientrecord storage on a user device.
 20. The one or more computer-readablemedia of claim 18, wherein performing the configuration test furthercomprises simulating authorization of a user device by the patientrecord gateway based at least in part on a set of test patientcredentials.